Chiropractic + Naturopathic Doctor

Keys to your practice: Death of the associateship

Angelo Santin   

Features Opinion

Finding a mutually beneficial alternative

My experience early in my career and what I have heard from some of the chiropractors I’ve mentored have led me to believe that the associateship model of practice is flawed.  

Having said this, I remember graduating from chiropractic college with fear and uncertainty toward starting my own practice. I also remember the comfort of having a senior partner there to look to for guidance.

Based on the latest data, average net income for Ontario chiropractors is around $45,000. There is definitely a need to look after your business in order to provide a living for yourself and your family.  


I would like to propose a different model of partnering up, with proven results for both parties involved.

Problem with associateship
Most often, these relationships are entered into solely to increase the bottom line for both doctors involved. Although having a successful business is important, maintaining good associate relationship requires both people to have similar values and beliefs about chiropractic. Often, this is not the case.  

Another problem is that expectations from both sides are often not met. The senior doctor is often looking to step away from practice while maintaining the patient base and income needs. The junior doctor often expects many things to be handed over with little financial output upfront. These relationships can be time-intensive, energy draining, and even stressful to the point that both practices often suffer as a result.

Re/Max model
The proven franchisee model of realty firm Re/Max has three main unique ideas when it comes to adding partners to their company. First, it offers low cost for franchisee partners to start up a franchise.  It can be as low as $30,000 to start selling real estate right away. Second, it offers great support to their franchisee partners, including training in all aspects of selling real estate. Their motto is, ‘why reinvent the wheel when it is already working so well?’ Lastly, they encourage autonomy when it comes to their franchise owners. Re/Max chairman and founder states, “I invite you to bring your own dreams of success to Re/Max.”

As a senior chiropractor, I would recommend setting up a “franchise fee” to enter into your office and practice. If you do an inventory of your office of everything from pens, to computers, to tables you can easily argue that a start-up cost of all of this could be between $50,000 and $100,000. If a junior chiropractor is aware of this, there should be no objections to paying half of this to enter into a practice.

The idea, though, is to not gouge them going forward. There is now no need to take a fifty percent share going forward. This kind of contract cripples the junior associate and often leads to an exit from the practice. If an initial upfront “franchise fee” is paid, negotiate a more reasonable fee that is beneficial for both parties. This can be done by having the junior chiropractor pay twenty five percent of billings to cover everything except staff cost.  

Why so low, you say? Let’s take another look at the Re/Max model more closely. The franchisee pays the initial fee for the right to use the name, for all the pre-eminence that comes with it, and other additional start-up costs. After this, however, the franchisee is responsible for paying all other major expenses including building costs and everything else in between. Therefore their ongoing franchise fees should be lower based on this information.

This model would work nicely in our profession as it puts some responsibility and autonomy on the junior chiropractor to manage their practice properly. It also rewards them handsomely when they do well. For the senior chiropractor, there is the need to offer support and training, a clean and neat office, and a positive work environment. After that, it’s time to sit back and let the junior chiropractor go to work offering encouragement along the way and collecting a nice, modest fee that can offset some of your expenses.  

The beauty of the Re/Max model is that if both sides are doing what they are supposed to do it will make it desirable and profitable for both sides to remain together.

Imagine a safe place for a young chiropractor to start a practice, have responsibilities, pay a fair fee, and succeed in practice. Imagine a seasoned chiropractor providing the necessary training, systems and encouragement for a younger chiropractor to flourish, while collecting a modest yet desirable fee in return.  

This is possible if we look to the models that have worked before and apply them with honesty and integrity. The profession could use better relationships in more offices as it provides for better patient care. After all, isn’t that what really matters?

Dr. Angelo Santin, DC, operates a busy subluxation-based family practice in Thunder Bay, Ont., and is president of the Thunder Bay Chiropractic Society. Santin is also a Carter Universal proficiency-rated chiropractic coach. He can be reached at or 807-344-4606.

Print this page


Stories continue below